Preliminary in vivo positional analysis of a posterior chamber phakic intraocular lens by optical coherence tomography and its correlation with clinical outcomes

PurposeTo analyze by spectral-domain optical coherence tomography the anatomical relationship of a specific type of posterior chamber phakic intraocular lens (pIOL) implanted in cases of high to moderate myopia with the adjacent intraocular structures and to correlate it with clinical outcomes.MethodsProspective observational case series including 18 eyes with high to moderate myopia (spherical equivalent between −5.88 and −15.75D) of 9 patients (age range, 29–49 years) undergoing bilateral Phakic Refractive Lens (PRL, Zeiss) implantation. Postoperative visual acuity, refraction, contrast sensitivity (CS), and ocular higher order aberrations (HOA) were evaluated. Furthermore, the in vivo position of the PRL was analyzed by means of spectral domain optical coherence tomography (3D OCT-1000, Topcon). Central (CENV), temporal (TEMV) and nasal vault (NASV) were measured. Correlation of these anatomical parameters with clinical data was also investigated. Mean follow-up was 47±25 months.ResultsA statistically significant visual and refractive improvement (p<0.01) was found postoperatively. Mean postoperative CENV, NASV, and TEMV were 157.88±69.93μm, 168.29±65.02μm, and 188.59±55.99μm, respectively. Significant difference was found between NASV and TEMV (p=0.01). No significant correlations were found between ocular aberrometric and anatomical parameters (p≥0.12). CENV, NASV and TEMV correlated significantly with 6-cycles per degree (cpd) photopic CS as well as with 18-cpd low mesopic CS (r≥0.57, p≤0.04). Furthermore, NASV also correlated significantly with preoperative anterior chamber depth (r=−0.65, p=0.01).ConclusionsThis posterior chamber pIOL shows a trend to nasal position, with potential impact on refractive and visual outcomes, particularly in eyes with deep anterior chambers